Provider Demographics
NPI:1992418248
Name:PELVIC CONNECTIONS PT, PLLC
Entity type:Organization
Organization Name:PELVIC CONNECTIONS PT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:JARONCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, PRPC
Authorized Official - Phone:631-942-6728
Mailing Address - Street 1:410 FARMINGTON AVE APT H1
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1983
Mailing Address - Country:US
Mailing Address - Phone:631-942-6728
Mailing Address - Fax:
Practice Address - Street 1:150 HAZARD AVE STE C6
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4587
Practice Address - Country:US
Practice Address - Phone:631-942-6728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy